Recovery and Psychiatric

Rehabilitation

Presented by
Payal Pradhan
 Psychiatric Care
 Goal of tertiary prevention is to limit the amount of disability
and maladaptive functioning resulting from an illness.

 Concepts of tertiary prevention relevant to patients with

serious mental illness.

 1 in 17 adults in USA have a serious mental illness.

 Nurses care for these people in a variety of settings:-

• Private and public psychiatric hospitals.

• Psychiatric and medical-surgical units in general hospitals.
• Emergency rooms.
• Community-based treatment and rehabilitation programs.
• Primary care settings.
• Patients homes.
 Rehabilitation
 Tertiary prevention is carried out through activities identified as
rehabilitation, which is the process of helping the person return
to the highest possible level of functioning.
 Psychiatric rehabilitation is a combination of services
incorporating social, educational, occupational, behavioral, and
cognitive interventions aimed at long-term recovery and
maximization of self-sufficiency.
 Psychiatric rehabilitation grew out of a need to create
opportunities for people diagnosed with severe mental illness to
live, learn, and work in their own communities.
 Psychiatric rehabilitation uses a person-centered, people-to-
people approach that differs from the traditional medical model
of care ( Table 14-1 ).
 Although research has reported that certain interventions
effectively assist people who have serious mental illnesses
function productively in their communities.

 The first group of disseminated evidence-based practices that

support and enhance psychiatric rehabilitation included the
following: assertive community treatment, supported
employment, illness management and recovery, integrated
treatment for co-occurring mental illness and substance abuse,
family psycho-education, and medication management.

 Rehabilitative psychiatric nursing takes place in the context of a

multidisciplinary treatment team.

 Other team members may include: psychiatrists, psychologists,

social workers, occupational therapists, rehabilitation counselors,
case managers, consumer team members, family advocates,
employment specialists, or job coaches.
 Recovery
 Recovery is the process in which people are
able to live, work, learn, and participate fully
in their communities.

 Recovery is a journey of healing and

transformation enabling a person with a
mental health problem to live a meaningful
life in a community of his or her choice while
striving to achieve his or her full potential.
 Characteristics of Serious Mental Illness
 People who have SMI are likely to have primary and secondary
symptoms.
 Primary symptoms are directly caused by the illness. For example,
hallucinations and delusions are primary symptoms of schizophrenia,
and elation and hyperactivity are primary symptoms of bipolar disorder.
 Secondary symptoms, such as loneliness and social isolation, are caused
by the person response to the illness or its treatment.

 Behaviors related to primary symptoms may violate social norms and be

considered deviant. Society tries to protect itself from the persons norm
violation. As behavior problems become more serious, people
increasingly identify themselves as mentally ill. They begin to relate to
society in terms of this identity rather than others, such as wife, mother,
husband, father, or worker. The persons acceptance of mentally ill
status and adjustment to society in terms of this role are accompanied
by the secondary symptoms of SMI.
 Social Support Needs
 Families who are providing care for members who have SMI
often feel isolated and alone in dealing with the challenges of
care giving.
 Previous sources of social support may be lost or limited
because of the demands of attending to the mentally ill family
member.
 Caregivers may be embarrassed about the illness or fear that
the person with mental illness will behave inappropriately in the
presence of others.
 Nurses can play an important role in offering family members
opportunities to discuss their concerns and taking action to meet
their needs whenever possible. Table 14-3 lists support needs
expressed by family caregivers.
 Developing strengths and
potential
 The development of the patient’s strengths and
potential is critically important. Nursing interventions
that develop strengths and potentials can help
patients develop independent living skills,
interpersonal relationships, and coping resources and
thus help meet their special needs.
 Ultimately, the expected outcome of such intervention
is change in the patient’s self-concept and an increase
in self-esteem. The negative self-concept and low
self- esteem that characterize people who have
serious mental illnesses interfere with their ability to
see the themselves as individuals with strengths and
potentials.
 Rehabilitation programs
psychiatric rehabilitation programs were
developed in response to the plight of
people who had been discharged from
state mental hospital lacking the skill and
resources needed to live independently
several models are presented here as an
over-view of some of the psychiatric
rehabilitation approaches that have
evidence supporting their effectiveness.
 CONCLUSION
 Evaluation of psychiatric rehabilitations
services usually covers the impact on the
patient and family and the effectiveness of
the community service system.
 Evaluation of the services provider to
patient and family member must focus on
the achievement of the expected outcome of
the intervention . Most psychiatric
rehabilitation evaluation program rely on
both objective and subjective measure of
outcome.